Retrospective Analysis Of Influencing Factors For Recurrence And Metastasis Of Breast Cancer After Operation

Objective: In this study,we aimed to analyze the influencing factors of recurrence or metastasis of breast cancer(BC)after the first treatment,and to provide ideas for optimizing the treatment of patients and reducing the risk of recurrence and metastasis of patients.Methods: In this study,641 BC patients with recurrence and metastasis confirmed pathologically or by imaging at the Breast Center of the Fourth Affiliated Hospital of Hebei Medical University from May 2008 to December2016 were collected.Electronic medical records were gathered by factors influencing recurrence or metastasis of BC after first treatment as identified in previous studies and clinical experience.X2 tests were performed for statistical values of continuous variables(size,mean,standard deviation,median,25% and 75% values),and percentages were compared for grouped variables.Univariate and multivariate Cox regression analysis and percentages were utilized to evaluate the risk factors of BC recurrence or metastasis after the first treatment.Statistical significance was considered at P < 0.05.SAS 9.2and SPSS 21.0 were used for statistical analysis.The variables,namely tumor T-stage,lymph node N-stage,hormone receptor status,pathological classification,lymph node status,surgical modality,whether neoadjuvant chemotherapy was administered,whether adjuvant chemotherapy was administered,whether targeted therapy was administered,and whether endocrine therapy was administered were subjected to univariate and multivariate analyses to assess the factors on recurrence and metastasis after the first treatment of BC and to explore feasible solutions to reduce the risk of recurrence and metastasis in BC patients.Results:This study included 641 cases with pathologically or imaging-confirmed first recurrent or metastatic BC.Categorized by local/regional recurrence and distant metastasis in the corresponding pattern,the statistics results revealed 264 patients with organ metastasis alone,184 patients with local/regional recurrence and 193 patients with both local/regional recurrence and organ metastasis.The median age of the enrolled patients was 48.0 years-old(range 23.0-82.0 years-old)and the median time to first recurrence of metastasis from BC was 25.0 months(range 3.0-153.0months).Univariate Cox analysis showed that larger tumor diameter,lymph node metastasis,pathological classification,hormone receptor status,and failure to receive standardized systemic therapy were all influencing factors for BC recurrence and metastasis.In contrast,in the multivariate Cox analysis,failure to receive standardized systemic therapy,including adjuvant chemotherapy,targeted therapy and endocrine therapy,remained an independent risk factor for unfavorable prognosis of BC,while the neoadjuvant chemotherapy,and radiotherapy,did not show significant benefit for the patients in this study.Conclusion: Larger tumor diameter,hormone receptor status,lymph node metastasis,and not receiving standardized systemic treatment are all dependent influencing factors for BC recurrence and metastasis.Raising the awareness of breast cancer screening,allowing patients to receive standardized treatment earlier,and regular follow-up after surgery will help to further reduce the recurrence and metastasis of breast cancer and prolong the survival of patients.At the same time,it is necessary to increase doctors’ business and communication skills,so that patients have a more full understanding of the standard treatment of breast cancer,so as to improve the awareness of the standard treatment of breast cancer patients.